| NPI | 1154474583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER BLACH Authorized Official/Officer 816-455-4214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 107.6) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2026-01-06 |